Systems and methods for removing exogenous particles from the skin of a patient

ABSTRACT

The present disclosure is directed to systems and methods that removing exogenous particles from a target region of the skin of a patient. The systems and methods can employ dermal lavage to remove the exogenous particles from the target region. In some instances, the exogenous particles can be residual tattoo ink after a tattoo removal process. A conduit can be sized and dimensioned for insertion into or around the target region to inject an irrigation fluid that defines an irrigation area. The exogenous particles can be suspended in the irrigation fluid. A device can be configured to form one or more channels in the irrigation area so that the exogenous particles are removable from the irrigation area.

RELATED APPLICATIONS

This application is a Divisional of U.S. application Ser. No.16/069,339, entitled “SYSTEMS AND METHODS FOR REMOVING EXOGENOUSPARTICLES FROM THE SKIN OF A PATIENT,” filed Jul. 11, 2018, which U.S.National Stage under 35 USC 371, claiming priority to Serial No.PCT/US2017/013548, entitled “SYSTEMS AND METHODS FOR REMOVING EXOGENOUSPARTICLES FROM THE SKIN OF A PATIENT,” filed Jan. 13, 2017, which claimsthe benefit of U.S. Provisional Application No. 62/278,014, entitled“SYSTEMS AND METHODS FOR REMOVING EXOGENOUS PARTICLES FROM THE SKIN OF APATIENT,” filed Jan. 13, 2016. The entirety of these applications ishereby incorporated by reference for all purposes.

TECHNICAL FIELD

The present disclosure relates generally to systems and methods forremoving exogenous particles from a target region of a patient's skinand, more particularly, to systems and methods for tattoo removal.

BACKGROUND

Tattoos are made by inserting ink or other colorant into the dermis ofthe skin. More than forty million people in the United States havetattoos, and many people will seek to have them removed. While tattoosare considered permanent, it is sometimes possible to fully or partiallyremove tattoos. Current tattoo removal technologies involve lasertreatments (e.g., using Q-switched lasers, picosecond lasers, or thelike). To remove the tattoo completely, a patient may be required toundergo a series of painful laser treatments (e.g., requiring 10-20sessions). Even with multiple sessions, the laser treatments can leavetattoo pigments remaining in the skin and/or create textural changes tothe skin, including scarring. Accordingly, many patients are unwillingto have their tattoo removed (even though they no longer want thetattoo) due to the associated time, cost and/or pain.

SUMMARY

The present disclosure relates generally to systems and methods forremoving exogenous particles from a target region of a patient's skinand, more particularly, to systems and methods for tattoo removal.

In one aspect, the present disclosure can include a method for removingexogenous particles from a target region of the skin of a patient. Themethod can include inserting one or more fluid conduits (e.g.,perforated fluid conduits, needles, or the like) into a portion of thepatient's skin to define an irrigation area in or around the targetregion. The method can also include injecting an irrigation fluid intothe irrigation area so that the exogenous particles become suspended inthe irrigation fluid. The method can also include removing theirrigation fluid from the irrigation area. In some instances, the methodalso can include creating localized edema through endogenous fluidaccumulation by injection of histamine, lipases, phospholipases,canthrone, podophylin, or the like.

In another aspect, the present disclosure can include a system forremoving exogenous particles from a target region of the skin of apatient. The system can include at least one conduit sized anddimensioned for insertion into or around the target region to define anirrigation area. The at least one conduit can be configured to inject anirrigation fluid into the irrigation area. The system can also include adevice configured to form one or more channels in the irrigation area sothat the exogenous particles are removable from the irrigation area withthe irrigation fluid.

In a further aspect, the present disclosure can include a method forremoving a tattoo from a target region of skin of a patient. The methodcan include shattering the tattoo in the target region into pigmentparticles. In some instances, the tattoo can be shattered by a laserremoval process. In some instances, the method can also include the useof enzymes (e.g., lipases, phospholipases, or the like) to free thetattoo particles from the cells. The method can also include suspendingthe pigment particles in the irrigation fluid. In other instances, themethod can also include adding chemicals to prevent re-phagocytosis ofthe tattoo particles with the use of sucrose, colchine, podophylin, etc.The method can also include removing the irrigation fluid and thesuspended pigment particles from the irrigation area. For example, theirrigation fluid can be removed from the irrigation area via at leastone channel through the surface of the skin of the patient.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other features of the present disclosure will becomeapparent to those skilled in the art to which the present disclosurerelates upon reading the following description with reference to theaccompanying drawings, in which:

FIG. 1 is a block diagram illustrating an example of a system forremoving exogenous particles from a target region of the skin of apatient according to an aspect of the present disclosure;

FIG. 2A is a block diagram illustrating an example of a wearable device;

FIG. 2B represents a top view indicating alternating pressure (o) andsuction (x) that can be applied by the example wearable device of FIG.2A;

FIG. 3 is a process flow diagram illustrating a method for removingexogenous particles from a target region of skin of a patient accordingto another aspect of the present disclosure;

FIGS. 4, 5, and 6A are schematic illustrations showing removal of theexogenous particles from the target region of the skin using the systemin FIG. 1;

FIG. 6B represents a top view indicating an example of alternatingpressure (o) and suction (x) that can be applied by FIG. 6A.

DETAILED DESCRIPTION Definitions

In the context of the present disclosure, the singular forms “a,” “an”and “the” can also include the plural forms, unless the context clearlyindicates otherwise.

The terms “comprises” and/or “comprising,” as used herein, can specifythe presence of stated features, steps, operations, elements, and/orcomponents, but do not preclude the presence or addition of one or moreother features, steps, operations, elements, components, and/or groups.

As used herein, the term “and/or” can include any and all combinationsof one or more of the associated listed items.

Additionally, although the terms “first,” “second,” etc. may be usedherein to describe various elements, these elements should not belimited by these terms. These terms are only used to distinguish oneelement from another. Thus, a “first” element discussed below could alsobe termed a “second” element without departing from the teachings of thepresent disclosure. The sequence of operations (or acts/steps) is notlimited to the order presented in the claims or figures unlessspecifically indicated otherwise.

As used herein, the term “exogenous” can refer to an element orsubstance that is placed into the body from an external source (e.g.,not natural to the body). Accordingly, the term “exogenous particle” canrefer to a particle that is placed into the body from an externalsource. In some instances, an exogenous particle can be an ink pigmentthat is placed in the skin of a patient. For example, the ink pigmentcan be a remnant of a tattoo created by a laser removal process.

As used herein, the term “laser removal process” can refer to a processthat uses a laser to shatter or fragment ink comprising a tattoo.Examples of laser removal processes can include Q-switched laser removalprocesses, picosecond laser removal processes, and the like. The terms“laser removal process” and “laser removal therapy” can be usedinterchangeably herein.

As used herein, the term “skin” can refer to the soft outer covering ofvertebrates, including the epidermis (e.g., the outermost layers ofcells in the skin) and the dermis (e.g., a layer of skin between theepidermis and subcutaneous tissue that cushions the body from stress andstrain).

As used herein, the terms “target region” and “target area” can be usedinterchangeably and can refer to an area of a patient's skin from whichone or more exogenous particles will be removed.

As used herein, the term “irrigation area” can refer to an area of apatient's skin that will be irrigated to remove exogenous particles. Insome instances, the irrigation area can be less than, greater than, orequal to the target area.

As used herein, the term “conduit” can refer to an element, structure,or component for conveying a fluid. The conduit can be internal (e.g.,needles, microneedels, or the like) and/or external (e.g., a containerhousing the solution) to a patient's skin. Additionally, when theconduit refers to an external conduit, the conduit can be in contactwith the patient's skin (e.g., a component used for electrophoresis,iontophoresis, or the like) or not in contact with the patient's skin.

As used herein, the term “channel” can refer to a passageway or conduitextending from an opening or hole at the surface of the skin to a depthunder the skin.

As used herein, the term “microchannel” can refer to a channel with adiameter less than about 1 mm. For example, a microchannel can be achannel that extends from an opening or hole in a patient's skin,through the epidermis, and into the dermis. As an example, amicrochannel can be created in a patient's skin by a needle, a laser, orthe like.

As used herein, the term “lavage” can refer to washing or irrigatingwith repeated injections of a fluid (e.g., water, saline, or otherbiocompatible fluid, which may include a pharmaceutical agent and/or anenzyme and/or any natural products or toxins, such as spider venom,snake venom, beetle venom, bee venom, or the like).

As used herein, the terms “subject” and “patient” can be usedinterchangeably and refer to any warm-blooded living organism including,but not limited to, a human being, a pig, a rat, a mouse, a dog, a cat,a goat, a sheep, a horse, a monkey, an ape, a rabbit, a cow, etc.

As used herein, the term “operatively coupled” can refer to two or morecomponents that are linked so that they perform their associatedfunction cooperatively and/or in combination.

Overview

The present disclosure relates generally to systems and methods forremoving exogenous particles from a target region of a patient's skinand, more particularly, to systems and methods for tattoo removal. Aftera single laser removal treatment, thousands of microscopic tattooparticles (e.g., exogenous particles) are released from cells in thedermis of the skin. While some of the exogenous particles are washedaway by the patient's lymphatic system, other exogenous particles remainin the skin. The remaining exogenous particles, which are engulfed bymacrophages and other phagocytes in the skin, essentially preserve thetattoo image. To remove these remaining exogenous particles completely,further laser removal treatments are required. Advantageously, thepresent disclosure describes systems and methods that can reduce oreliminate the need for further laser removal treatments. In someinstances, the systems and methods themselves can eliminate exogenousparticles from the patient's skin without the need for an initial laserremoval treatment. As discussed in more detailed below, the presentdisclosure provides systems and methods that employ dermal lavage toremove the remaining exogenous particles from a target region of thepatient's skin.

Systems

One aspect of the present disclosure can include a system for removingexogenous particles (e.g., ink particles from a tattoo or residual inkparticles in a patient's skin after a tattoo removal process) from atarget region of the skin of the patient. The system can utilize dermallavage to remove the exogenous particles. In some instances, a fluidconduit (e.g., a perforated conduit, one or more microneedles, one ormore coring needles, or the like) can be inserted into or around thetarget region to define an irrigation area. An irrigation fluid can beinjected into the irrigation area via the fluid conduit. A device (e.g.,a channel formation device) can be configured to form one or morechannels in the irrigation area so that the exogenous particles areremovable from the irrigation area (e.g., via suction or passivediffusion) along with the irrigation fluid.

FIG. 1 illustrates one example of a system 10 for removing exogenousparticles from a target region of the skin of a patient. In someinstances, before removing the exogenous particles from the skin, one ormore layers of the skin (e.g., the epidermis) can be removed tofacilitate removal of the exogenous particles. For example, a suctionblister can be created to remove one or more layers of skin. In anotherexample, a fractional laser (e.g., an ablative laser, such as an erbiumablative laser or a CO₂ ablative laser) can be used to remove one ormore layers of skin. The layers of skin can be removed without scarring(e.g., by use of coring needles or a laser) to improve conventionaltattoo removal (e.g., 10% ablation can lead to 10% of the skin/tattoobeing removed).

The system 10 can include a fluid source 12, a fluid conduit 14, and achannel formation device 16. Further, as described below, the system 10can additionally or optionally include one or more pressure devices (notshown) or device(s) (not shown) for imparting a mechanical force on theskin surface. Such pressure devices and/or devices for imparting amechanical force on the skin surface can be integrated with, operablycoupled to, or entirely separate from the fluid source 12, the fluidconduit 14, and/or the channel formation device 16.

As an example, at least a portion of the system 10 can be integratedwithin a wearable device for removal of the exogenous particles. In thesimplest example, the fluid conduit 14 can be one or more hypodermicneedles that inject the irrigation fluid from the fluid source 12 intothe irrigation area of the patient. The wearable device, which caninclude the channel formation device 16 (e.g., a laser, one or moreneedles, one or more microneedles, a coring needle, one or more rollingneedles, or the like), can be placed over the irrigation area for a timeperiod to facilitate the removal of the irrigation fluid and theexogenous particles from the irrigation area. In this example, anexternal negative pressure can be created in a passive manner, such asby movement of the patient's body, which can facilitate the removal ofthe irrigation fluid and the exogenous particles. The wearable devicecan also include a reservoir or absorbent material to store the fluidand the exogenous particles removed from the patient's skin. As anotherexample, the wearable device can also include an active pressure sourceand an accompanying battery. In a further example, the wearable devicecan include the fluid conduit 14 and the fluid source 12 as a pluralityof dissolvable needles (e.g., carbodymethyl cellulose) arranged in anarray, each composed of (e.g., filled with) a bolus of irrigation fluid.As the dissolvable needles dissolve, the irrigation fluid can betransported to the irrigation area. In addition to these examples, thewearable device may include additional components. Additionally, it willbe noted that the suction can be more effective the longer thealternating pressure, such as positive and negative pressure, suction orpressure is applied (e.g., the suction or pressure being applied for 0,2, 4, 6, 8, 12, or 24 hours or more would be increasingly moreeffective).

FIG. 2A shows an example of a wearable device to aid in the lavage ofthe tattoo ink. The device is held tightly to the skin with an adhesivepatch. Small conduits (fluid conduit 14) can enter the skin andpressurized fluid could pass through them. The center chamber (channelformation device 16) allows alternating suction (o) and pressure (x)(shown in FIG. 2B) to flow such that when suction is on, the skin ispulled into the chamber and small conduits pierces the skin and allowssuction (o) within the skin to occur, simultaneously causing fluid flowthrough. After a time, pressure (+) is forced into the chamber andpushes down on to the skin causing movement of the ink particles andflow through the conduits stops. This cycle continues in an alternatingpattern. Suction and pressure times could be equal or suction time couldbe longer then pressure time.

Referring again to FIG. 1, the fluid source 12 can supply an irrigationfluid to the fluid conduit 14, which can be operatively coupled to thefluid source. The irrigation fluid can be a bolus of liquid (e.g., inthe range of about 10-50 mL), which is injected through the fluidconduit 14 (e.g., a needle, catheter, or cannula) to the target area tobe irrigated. In one example, the fluid source 12 can be a reservoir forthe irrigation fluid (e.g., an IV bag). In some instances, theirrigation fluid can be a biocompatible fluid, such as saline, sterilewater, or the like. In other instances, the exogenous fluid can includean enzyme, natural compound, and/or a pharmaceutical agent. The enzymeor pharmaceutical agent can at least one of lyse cells, make the skinmore porous (e.g., by breaking up the tight connections between collagenfibers in the dermis), prevent or inhibit phagocytosis, or otherwisefacilitate removal of the irrigation fluid. Examples of enzymes orpharmaceutical agents that can be within the irrigation fluid includehyuronidase, collegenase, phospholipase, cantherone, colchicine,podophylin, hyaluronic acid, pederine, and sucrose. Examples of anatural compound (e.g., a venom or poison) that can be included in theirrigation fluid include natural or diluted forms of venoms, such asspider, snake, beetle, or bee. In other instances, the enzyme or otherchemical agent can be injected before or after the exogenous fluid. Forexample, the target area can undergo a pre-treatment with histamine,lipase, and/or phospholipase, causing the target area to undergo aninflammatory reaction, which can induce edema and endogenous fluidcollection/flow to improve draining of the exogenous particles.

In other instances, the fluid can be an endogenous fluid (e.g., derivedor obtained from the patient's body). For example, the endogenous fluidcan come from local dermal edema. The patient can be injected with adrug, such as a histamine, that is known to cause local dermal edema inthe target region of the skin. The fluid can leave the target regionthrough holes or channels formed by the channel formation device 16,thereby removing the edema and, in the process, washing out theexogenous particles.

In one example, the exogenous particles can include ink particles from atattoo. In another example, the exogenous particles can be residualtattoo ink particles formed as a result of a tattoo removal process. Ineither example, the dermal lavage can inject an irrigation fluid into anirrigation area (e.g., an area including at least a portion of theresidual tattoo ink) so that the fluid and the residual tattoo inkparticles are removed from the skin via one or more holes or channelsformed in the target area of the skin by the channel formation device16.

The fluid conduit 14 can be inserted into a subject's skin in theproximity of the target area. In some instances, the fluid conduit 14can be inserted around the target area. In other instances, the fluidconduit 14 can be inserted into the target area. The irrigation area canbe defined by the injected irrigation fluid , which can be from thefluid source 12.

At least a portion of the exogenous particles in the irrigation area canbe suspended in the irrigation fluid as a result. In one example, atleast 50% of the exogenous particles in the irrigation area can besuspended in the irrigation fluid. In another example, at least 75% ofthe exogenous particles in the irrigation area can be suspended in theirrigation fluid. In yet another example, 100% of the exogenousparticles in the irrigation area can be suspended in the irrigationfluid.

The channel formation device 16 can be configured to create one or moreholes or channels that extend through a portion of the irrigation area.In some instances, the channel formation device 16 can include one ormore microneedles. In other instances, the channel formation device 16can include a laser or an array of a plurality of lasers. In furtherinstances, the channel formation device 16 can be a tattoo gun withoutany ink (“reverse tattooing”). In one example, the channel formationdevice 16 is configured to form one or more holes or channels, each ofwhich extends through the epidermis into the dermis. Holes or channelsformed by the channel formation device 16 can each have a hydraulicdiameter of about 10 mm or less, about 5 mm or less, or about 1 mm orless. In some instances, holes or channels formed by the channelformation device 16 can be microchannels (e.g., having a diameter of atleast about 500 □m). In other instances, an anti-clotting drug, likeheparin, aspirin, an NSAID, or other anticoagulant can be used toprevent the closure of the holes or channels formed by the channelformation device 16.

Irrigation fluid, in some instances containing a pharmaceutical agentand/or an enzyme, can be injected into the skin and flow into the one ormore holes or channels and then exit the skin with the suspendedexogenous particles. In some instances, fluid flow through the holes(s)or channel(s) happens automatically when the hole(s) or channel(s)is/are created in the skin. In other instances, fluid flow occurs uponapplication of an external stimulus to the target area (e.g., pressureon the surface of the skin by a gloved finger of a medicalprofessional). In still other instances, fluid flow occurs uponapplication of suction or negative pressure (e.g., from a suctiondevice, such as a breast pump, a wound vacuum, or the like) to thetarget region. Prior to applying suction, a mechanical force (e.g., avibration or shock wave) can be applied to the target region to break upattachment of the exogenous particles from the surrounding tissue andmake the particles more mobile. As an example, a vibrator can be used asa tool to loosen the exogenous particles. Alternatively, the mechanicalforce(s) can be applied to the target region following laser therapy(but before formation of the holes or channels) and/or at any pointprior to applying suction to the target region.

Suction can be applied continuously or intermittently. Alternatively,suction can be applied in a cyclic manner along with positive pressureto generate a massaging action on the skin and thereby facilitatemigration of the exogenous particles to the skin surface. In someinstances, the intensity of the suction can be changed over time andthus be applied as a gradient of increasing or decreasing negativepressure.

In some instances, fluid flow can remove about 25% or more of theexogenous particles from the irrigation area, about 50% or more of theexogenous particles from the irrigation area, or about 75% or more ofthe exogenous particles from the irrigation area.

Methods

Another aspect of the present disclosure can include a method 20 (FIG.3) for removing exogenous particles (e.g., a tattoo, residual inkparticles in a patient's skin, or the like) from a target region of apatient's skin. The method 20 of FIG. 3 is illustrated as a process flowdiagram. For purposes of simplicity, the method 20 is shown anddescribed as being executed serially; however, it is to be understoodand appreciated that the present disclosure is not limited by theillustrated order as some steps could occur in different orders and/orconcurrently with other steps shown and described herein. Moreover, notall illustrated aspects may be required to implement the method 20. Themethod 20 will be explained with regard to FIGS. 4-6, which illustratethe removal of exogenous particles from a target region of a patient'sskin (e.g., using the system 10 described above).

FIG. 4 is a schematic illustration 30 showing exogenous particles 38located under the surface of a patient's skin 32. The exogenousparticles 38 can include residual tattoo ink particles that remain inthe patient's skin after a tattoo removal process (e.g., a Q-switchedlaser tattoo removal procedure, a picosecond laser tattoo removalprocedure, or the like). For example, the exogenous particles 38 can belocated in the dermis 36 within a target area 39. In this case, thetarget area 39 can be defined as an area within the dermis 36 thatincludes a majority of the exogenous particles 38. For example, thetarget area 39 can include about 50% or more of the exogenous particles38, about 75% or more of the exogenous particles, or about 100% of theexogenous particles (e.g., at least about 98% or more). In someinstances, before removing the exogenous particles from the skin, one ormore layers of the skin (e.g., the epidermis 34) can be removed tofacilitate removal of the exogenous particles (as discussed above).

At Step 22, a fluid conduit 14 (FIG. 5) can be inserted into a portionof a patient's skin. The fluid conduit 14 can be operatively coupled tothe fluid source 12 and then inserted through the dermis 36 of thepatient's skin 32 to define the irrigation area. As shown in FIG. 5, thefluid conduit 14 can be a tube-like structure (e.g., made of abiocompatible polymer) and/or one or more needles (e.g., microneedles,coring needles, or the like), which can inject the irrigation fluid intothe target area. Although a single fluid conduit 14 is illustrated, itwill be appreciated that a plurality of fluid conduits can be placed toinject the irrigation fluid that defines the irrigation area. It willalso be appreciated that multiple fluid sources 12 can be used todeliver fluid to the irrigation area.

Next, at step 24, the irrigation fluid can be injected through the fluidconduit 14 to irrigate the irrigation area. For example, a bolus of theirrigation fluid (e.g., in the range of about 10-50 mL) can be flowedfrom a fluid source 12, through the fluid conduit 14, and into thetarget region. In some instances, the exogenous fluid can include anenzyme or a pharmaceutical agent (e.g., hyuronidase, collegenase,phospholipase, cantheradin, cochicine, sucrose, or any other type ofenzyme or pharmaceutical agent that can lyse cells, inhibitphagocytosis, keep the exogenous particles free for as long as possible,or the like) or other chemical agent capable of breaking up the tightconnections between collagen fibers in the dermis, thereby allowing theirrigation fluid and the exogenous particles to more easily flow out ofdermis. In some instances, the enzyme or pharmaceutical agent can be apart of the irrigation fluid. However, in other instances, the enzyme orother chemical agent can be injected before or after the irrigationfluid.

In other instances, the irrigation fluid can be an endogenous fluid. Forexample, the endogenous fluid can come from local dermal edema. Thepatient can be injected with a drug, such as a histamine that is knownto cause local dermal edema in the target region of the skin. The fluidcan leave the target region through holes or channels formed by thechannel formation device 16, thereby removing the edema and, in theprocess, washing out the exogenous particles.

As shown in FIG. 5, the irrigation fluid exits fluid conduit 14 toirrigate the irrigation area (Step 26). As a result, exogenous particles38 located in the irrigation area are suspended in the irrigation fluid.

At Step 26, the irrigation fluid is removed from the irrigation areathrough holes or channels formed in the portion of the patient's skin.As shown in FIG. 6A, a plurality of channels 62-68 (e.g., that enter thedermis 36 through the epidermis 34) can be created within the irrigationarea by the channel formation device 16 using, for example, one or moremicroneedles, one or more coring needles, and/or one or more lasers. Infurther instances, the channel formation device 16 can be a tattoo gunwithout any ink. Although four channels 62-68 are illustrated, anynumber of one or more channels can be created. Additionally, althoughthe channels 62-68 are illustrated as being rectangular, other shapescan be used to perform the same function (e.g., triangular, rounded,square, or the like). Moreover, the channels 62-68 can be separatechannels (as illustrated) or at least partially connected oroverlapping. The channels 62-68 can be created while the irrigation areais being irrigated. However, it will be appreciated that the channels62-68 can be created either before the irrigation or after theirrigation. In other instances, an anti-clotting drug, like heparin,aspirin, an NSAID, or other anticoagulant can be used to prevent theclosure of the channels formed by the channel formation device 16.

In some instances, the fluid can be removed automatically. In otherinstances, the fluid requires a catalyst for removal, such as pressureon the patient's skin 32 by a gloved finger of a medical professional ora device that introduces suction. In some instances, about 25% or moreof the exogenous particles can be removed along with the fluid. In otherinstances, about 50% or more of the exogenous particles can be removedalong with the fluid. In still other instances, about 75% or more of theexogenous particles can be removed along with the fluid.

In some instances, fluid flow into the channel(s) happens automaticallywhen the channel(s) is/are created in the skin. In other instances,fluid flow occurs upon application of an external stimulus to the targetarea (e.g., pressure on the surface of the skin by a gloved finger of amedical professional). In still other instances, fluid flow occurs uponapplication of suction, positive pressure (+), negative pressure (−), ora combination thereof (e.g., from a suction device, such as a breastpump, a wound vacuum, or the like) to the target region. As one example,different pressure patterns can be applied, like −+−, −−−+−−−+−−−+, orthe like). As another example, pressure (+) and suction (o) can beapplied as shown and described with respect to FIG. 2B. As a furtherexample, shown in FIGS. 6A and 6B, the pressure (+) and suction (o) canbe applied together through alternating conduits.

Prior to applying suction, a mechanical force (e.g., a vibration orshock wave) can be applied to the target region to break up attachmentof the exogenous particles from the surrounding tissue and make theparticles more mobile. Alternatively, the mechanical force(s) can beapplied to the target region following laser therapy (but beforeformation of the channels) and/or at any point prior to applying suctionto the target region.

Suction can be applied continuously or intermittently. Alternatively,suction can be applied in a cyclic manner along with positive pressureto generate a massaging action on the skin and thereby facilitatemigration of the exogenous particles to the skin surface. In someinstances, the intensity of the suction can be changed over time andthus be applied as a gradient of increasing or decreasing negativepressure.

The dermal lavage provided by the method 20 facilitates removal ofexogenous particles 38 from the patient's skin 32. For example, thedermal lavage provides a more effective treatment for tattoo removal byreducing the number of laser therapies required to remove the tattoo.This is accomplished by removing the exogenous particles 38 beforeand/or after they are engulfed by macrophages or other phagocytes in thepatient's skin 32. Consequently, any residual tattoo particles remainingafter laser therapy are less visible and/or invisible.

From the above description, those skilled in the art will perceiveimprovements, changes and modifications. Such improvements, changes andmodifications are within the skill of one in the art and are intended tobe covered by the appended claims.

What is claimed is:
 1. A device configured to remove exogenous particlesfrom skin, the device comprising: a housing; at least one fluidinjection mechanism within an outer section of the housing configured toinject an irrigation fluid into the skin to define an irrigation area,wherein the exogenous particles are removeable from the irrigation areawith the irrigation fluid; and a pressure/suction mechanism within aninner section of the housing configured to alternate pressure andsuction to the irrigation area to facilitate removal of the irrigationfluid and at least a portion of the exogenous particles from theirrigation area.
 2. The device of claim 1, wherein the inner section ofthe housing is configured to form one or more channels within a portionof the irrigation area, wherein the irrigation fluid and the at leastthe portion of the exogenous particles are removed through the one ormore channels.
 3. The device of claim 2, wherein the inner section ofthe housing comprises at least one microneedle or coring needle to formthe one or more channels within the portion of the irrigation area. 4.The device of claim 2, wherein the inner section of the housing isconfigured to draw a portion of the irrigation area therein to form theone or more channels within the portion of the irrigation area.
 5. Thedevice of claim 1, wherein the irrigation area is within a dermis of theskin.
 6. The device of claim 1, further comprising an adhesive materialalong at least a portion of the housing to attach the housing to theskin.
 7. The device of claim 6, wherein the housing comprises a domedportion to be placed away from the skin and a substantially flat portionto be placed on the skin, wherein the adhesive material is along atleast a portion of the substantially flat portion.
 8. The device ofclaim 1, wherein the irrigation fluid comprises a biocompatible fluidand an additive.
 9. The device of claim 8, wherein the additive is apharmaceutical agent, an enzyme, a natural product, and/or a venom. 10.The device of claim 8, wherein the additive is capable of at least oneof lysing cells, making the skin more porous, preventing or inhibitingphagocytosis, creating localized edema, and facilitating removal of theirrigation fluid.
 11. The device of claim 8, wherein the biocompatiblefluid comprises at least one of saline and water.
 12. The device ofclaim 1, wherein the irrigation fluid comprises a pressurized fluid. 13.A method for removing exogenous particles from skin, the methodcomprising: attaching a device to the skin; injecting an irrigationfluid into the skin to define an irrigation area, wherein the exogenousparticles are removeable from the irrigation area with the irrigationfluid; and alternating pressure and suction to the irrigation area toremove the irrigation fluid and at least a portion of the exogenousparticles from the irrigation area.
 14. The method of claim 13, whereinthe device comprises a housing, at least one fluid injection mechanismwithin an outer section of the housing configured to inject theirrigation fluid into the skin to define the irrigation area, and apressure/suction mechanism within an inner section of the housingconfigured to alternate pressure and suction to the irrigation area. 15.The method of claim 14, further comprising forming one or more channelswithin a portion of the irrigation area, wherein the irrigation fluidand the at least the portion of the exogenous particles are removedthrough the one or more channels.
 16. The method of claim 15, furthercomprising drawing a portion of the irrigation area into the innersection of the housing to form the one or more channels within theportion of the irrigation area.
 17. The method of claim 13, wherein theapplying further comprises using an adhesive material along at least aportion of the housing to attach the housing to the skin.
 18. The methodof claim 17, wherein the housing comprises a domed portion to be placedaway from the skin and a substantially flat portion to be placed on theskin, wherein the adhesive material is along at least a portion of thesubstantially flat portion.